For a patient with a history of unprovoked deep vein thrombosis, what should be avoided in treating menopausal symptoms?

In patients with a history of unprovoked deep vein thrombosis (DVT), hormone replacement therapy (HRT) should be avoided when treating menopausal symptoms. This is primarily due to the increased risk of thromboembolic events associated with the use of estrogen, which is a core component of many HRT regimens. Estrogen can promote clotting factors and venous stasis, leading to a greater likelihood of thrombotic complications, which poses a significant risk for individuals with a history of DVT.

In contrast, SSRIs are often recommended for treating menopausal symptoms such as hot flashes and mood disorders. Exercise programs and dietary changes are beneficial lifestyle modifications that support overall health and can help alleviate mild menopausal symptoms without the associated risks of hormone therapy. Therefore, while these options can be part of a comprehensive approach to managing menopausal symptoms, HRT should be approached with caution or avoided altogether in those with a history of thromboembolic disease.